{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T12:04:59Z","timestamp":1765713899745},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T00:00:00Z","timestamp":1482883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Syphilis in pregnancy can lead to fetal and neonatal death or congenital anomalies. Accurate on\u2010site tests are an essential part of effective prevention of mother\u2010to\u2010child transmission of the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This systematic review assessed the accuracy of on\u2010site tests to detect infection with <jats:italic>Treponema pallidum<\/jats:italic> in pregnant women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>Major databases were searched from inception to January 2016 using terms: \u2018pregnancy\u2019, \u2018antenatal\u2019, \u2018syphilis\u2019, \u2018<jats:italic>Treponema pallidum<\/jats:italic>\u2019 with their variations, and the search limit for the relevant study design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>We included studies that used dual reference standard (non\u2010treponemal and treponemal tests) to detected syphilis in pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Extracted accuracy data were tabulated and pooled using hierarchical, bivariate random effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Seven studies (combined sample 17\u00a0546) reporting the accuracy of four on\u2010site tests met the eligibility criteria. On average, Determine\u2122 and <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> BioLine Syphilis 3.0 had the highest sensitivity of all the evaluated tests: 0.83 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.58, 0.98) and 0.86 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.82, 0.89), respectively, with a high specificity 0.96 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.89, 1.00) and 0.99 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.94, 1.00), respectively. The Qualitative Rapid Plasma Reagin card commonly used in clinical practice had a pooled sensitivity of 0.70 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.54, 0.88) and specificity of 0.97 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.96, 0.99).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Immunochromatographic tests such as Determine\u2122 and <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> BioLine Syphilis 3.0 seem to be acceptable options in antenatal testing for syphilis, especially in resource\u2010limited settings. Future research should seek more evidence to strengthen this claim.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>On\u2010site test to detect syphilis\u2014options during antenatal care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14455","type":"journal-article","created":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T10:24:07Z","timestamp":1482920647000},"page":"734-741","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["On\u2010site test to detect syphilis in pregnancy: a systematic review of test accuracy studies"],"prefix":"10.1111","volume":"124","author":[{"given":"E","family":"Rogozi\u0144ska","sequence":"first","affiliation":[{"name":"Women's Health Research Unit Blizard Institute Barts and the London School of Medicine and Dentistry London UK"},{"name":"Multidisciplinary Evidence Synthesis Hub (mEsh) Centre for Primary Care and Public Health Blizard Institute Barts and the London School of Medicine and Dentistry London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Kara\u2010Newton","sequence":"additional","affiliation":[{"name":"Women's Health Research Unit Blizard Institute Barts and the London School of Medicine and Dentistry London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JR","family":"Zamora","sequence":"additional","affiliation":[{"name":"Women's Health Research Unit Blizard Institute Barts and the London School of Medicine and Dentistry London UK"},{"name":"Clinical Biostatistics Unit Hospital Ramon y Cajal (IRYCIS) and CIBER Epidemiology and Public Health Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KS","family":"Khan","sequence":"additional","affiliation":[{"name":"Women's Health Research Unit Blizard Institute Barts and the London School of Medicine and Dentistry London UK"},{"name":"Multidisciplinary Evidence Synthesis Hub (mEsh) Centre for Primary Care and Public Health Blizard Institute Barts and the London School of Medicine and Dentistry London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,12,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2013.08.005"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.107623"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001396"},{"key":"e_1_2_6_5_1","unstructured":"WHO.The Global Elimination of Congenital Syphilis: rationale and strategy for action.2007. apps.who.int\/iris\/bitstream\/10665\/43782\/1\/9789241595858_eng.pdf"},{"key":"e_1_2_6_6_1","first-page":"439","article-title":"Diagnostic tools for preventing and managing maternal and congenital syphilis: an overview","volume":"82","author":"Peeling RW","year":"2004","journal-title":"Bull World Health Organ"},{"key":"e_1_2_6_7_1","unstructured":"WHO The Sexually Transmitted Diseases Diagnostics Initiative (SDI).The use of rapid syphilis tests. 2006 WHO reference number: WHO\/TDR\/SDI\/06.1www.who.int\/reproductivehealth\/publications\/rtis\/TDR_SDI_06_1\/en\/"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0054695"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70092-X"},{"key":"e_1_2_6_10_1","unstructured":"Centers for Disease Control.Guidelines for the Prevention and Control of Congenital Syphilis. 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